A virtual voyage on a treacherous Sunday

Audrey Barker maneuvered so she could point her iPad’s camera and flashlight down her daughter’s throat.

Outside their Caledonia, Michigan, home, winter’s last breath had exhaled a rain of ice across the landscape. It had become unsafe to drive, forcing Audrey and her daughter, Holly Barker, to spend that Sunday afternoon indoors.

“People were getting horrible reports on the road,” Audrey, 34, remembered. Schools across West Michigan closed the following day.

Still, Holly’s sore throat needed swift attention.

“We would have ended up going to urgent care,” Audrey said.

She recalled a friend’s recommendation to try a Spectrum Health service: MedNow. It connects patients to physicians or advance care providers through video calls or e-visits with private messages. It’s open to anyone in Michigan and callers don’t even need to be Spectrum Health patients.

Just like that, on a snow afternoon, mother and ailing daughter quickly found themselves online, consulting via video with Spectrum Health physician assistant Ryan Miller.

Some 20 miles north, at Spectrum Health Butterworth Hospital in Grand Rapids, Michigan, Miller studied his computer monitor, evaluating 13-year-old Holly’s throat.

“It was real easy to do,” Audrey said. “We downloaded the app and we were able to FaceTime. It was actually kind of fun. He was a super person, not intimidating at all—zero percent with a frazzled mother with a topknot and yoga pants.”

The prognosis: a viral bug.

Rising demand

Miller spends at least eight hours a week serving patients on MedNow.

Lately, closer to 16 hours.

“I think it has its place if it’s for … the very low-acuity things that can be seen,” Miller said. “It definitely has saved the ER from being clustered. And it saves time for the customer, especially if you have to drive 20 miles.”

Since MedNow launched four years ago, Spectrum Health has evaluated 50,000 patients for conditions such as cold, flu, diarrhea, earache, fever, nausea, pink eye, sore throat and such.

Direct-to-consumer sessions with a health professional are most common. Clinical sessions—say, with a cardiologist or other specialist—account for the rest.

MedNow recommends patients call 911 or head to the nearest emergency room if they’re experiencing dizziness, numbness, paralysis, difficulty speaking or loss of consciousness, chest pain, shortness of breath, sweating, severe abdominal pain, seizures or any other condition that would require urgent medical care.

But for non-emergency conditions, MedNow is a viable option.

Participation in MedNow has grown exponentially over the past year, with Spectrum Health recording 20,000 direct-to-patient cases and about 9,000 clinical sessions, said Mandy Reed, MedNow’s operations director.

“When we started out, volume was very low,” Reed said. “But we’ve grown over 200 percent every year.”

As face-to-face technology has grown, especially with software like Skype and FaceTime, online medical visits have become more common, largely in the past five years.

Also driving the numbers in Michigan is a new app developed specifically for Spectrum Health, in September 2017.

“That really launched a whole new advanced experience for us,” Reed said. “We did not want to just give a boxed product (from a third party) to consumers. We wanted to create it, to allow an easier experience and enable. We don’t use technology for technology’s sake.”

Joseph Brennan, MedNow senior director, would agree.

“We wanted to build a dedicated app from the beginning, but first we needed input from our consumers,” Brennan said in announcing the app. “We took that feedback and used it to improve upon the MedNow experience.”

The app is free on iPhone and Android devices.

Affordable care

MedNow isn’t just a matter of convenience. It’s also about helping patients save money.

A MedNow visit costs $45, which is often covered by insurance. Sessions may be scheduled directly through the app downloaded to a cell phone, computer, laptop, iPad or tablet.

“All you need is a phone and Wi-Fi,” said Miller, who also works in psychiatry and behavioral medicine at Spectrum Health.

For Audrey, that meant MedNow ended up being nearly five times less expensive than an urgent care visit.

About two weeks before the MedNow call, while on spring break, Holly’s ear began to hurt. Audrey, worried about an infection, opted to get her daughter’s ear checked right away.

Their visit to an urgent care clinic cost $245. MedNow would have saved them $200.

“I wish we knew about (MedNow) then,” Audrey said.

“The (MedNow) experience was really good,” Holly said. “They were very personal. I like how he asked questions. He would repeat the questions and repeat the answers just to make sure.”